Objective:To observe the correlation analysis between the deep-superficial flow-density ratio (DSFR) and treatment response of macular edema secondary to branch retinal vein occlusion (BRVO).Methods:Forty-eight patients (48 eyes) with macular edema secondary to BRVO from December 2018 to December 2019 in the Department of Ophthalmology of Beijing Hospital were enrolled in this study. There were 29 males (29 eyes) and 19 females (19 eyes), with the mean age of 58.77±10.88 years. All eyes were treated with intravitreal injection of ranibizuma once a month for 3 months, and then treated as needed. According to the central retinal thickness (CRT) 12 months after treatment, the patients were divided into good response group (CRT≤250 μm) and refractory group (CRT> 250 μm). The flow density in the superficial capillary plexus (SCP) and deep capillary plexus (DCP) of all subjects was measured by optical coherence tomography angiography. The flow density of DCP and SCP measured at 3 follow-up times was selected and DSFR was calculated. The DSFR was recorded by the Study for the Treatment of Diabetic Retinopathy (ETDRS) -grid and Nine-grid. The flow density of DCP, SCP and DSFR were compared between the two groups by paired t test. At 3 months post-treatment, the efficacy of DSFR in ME treatment response was evaluated according to area under curve (AUC) of receiver operating characteristic. Univariate and multivariate binary logistic regression were used to analyze the factors affecting the response to ME treatment. Results:At 12 months after treatment, there were 27 eyes in good response group and 21 eyes in refractory group. There was no statistical significance in the flow density of DCP ( t=1.804, 1.064, 0.660) and SCP ( t=0.581, 0.641, 0.167) and DSFR ( t=0.393、-0.553、0.474) in all area of response group and refractory group using ETDRS-GRID recording method ( P>0.05). The SCP, DCP and DSFR of the most severe non-perfusion area were (27.10±5.70) %, (28.33±8.95) %, 1.35±0.54 and (27.54±6.70) %, (29.11±0.42) %, 1.01±0.40 in the response group and refractory group, respectively. There was no significant difference in the flow density of DCP and SCP between the two groups ( t=-0.237,-0.340; P>0.05). The difference of DSFR between two groups was statistically significant ( t=2.288, P=0.024). Univariate and multivariate binary logistic regression analysis showed that DSFR in the most severe non-perfusion area was associated with ME response (odds ratio=0.212, 0.085; P=0.027, 0.024). The AUC was used to evaluate the efficacy of DSFR in ME treatment response, the results showed that the AUC was 0.800, P=0.001, Youden index was 1.348, sensitivity was 67.7%, and specificity was 86.7%. Conclusions:DSFR reduction is more common in BRVO secondary to ME patients. DSFR correlates with ME treatment response.

Thyroid carcinoma is the most common malignant tumor in the endocrine diseases,with a rising morbidity.As more investigations were made,thyroid stimulating hormone receptor is showed up,and it is believed some contacts are existed between thyroid stimulating hormone receptor and thyroid carcinoma.We believe that making sure of these contacts can help patients in diagnosis,treatment,and prognosis.

Objective To establish the method of content determination of Piperine in Biba Zhitong Tincture.Methods HPLC was adopted in determining the content of piperine in Biba Zhitong Tincture.C18 chromatographic column was used with the column temperature being the room temperature.The mobile phase was tetrahydrofuran-methanol-water(V∶V∶V=30∶30∶50)with the velocity of 1.0 mL/min.The detection wavelength was 343nm,and the sampling volume was 10?L.External standard method was chosen for content calculation.Results The inner peak area of piperine(8.3～41.5 mg/L)showed fine linear relation with mass concentration of control group.Its regression equation was A=3413186?-7467.7,r= 0.999 8,with the average recovery ration being 99.7%,and RSD=1.8%(n=6).Conclusion The method is simple,convenient,good reproducibility and non-interference,and can effectively control the quality of the preparation.

Objective To observe and measure the Doppler sonographic features of benign and malignant ovarian neoplasms,which included morphology and hemodynamics of tumor angiogenesis,and to select the most significant features. Methods Ninety-five patients with one hundred and five ovarian tumors were examined preoperatively by power Doppler sonography to observe the morphology of tumor angiogenesis. The hemodynamic features of tumor angiogenesis referred for pulsed Doppler sonography evaluation were measured,which included peak systolic velocity(V PS ),end diastolic velocity(V ED ),mean flow velocity(V M),pulsatility index(PI),resistance index(RI) and diastolic notch. To assess the variables jointly,stepwise regression analysis was used to identify the group of features that allowed the best prediction of benignity versus malignancy. Results All Doppler features significantly associated with malignancy .The ROC curve of RI revealed that the cutoff of RI( 0.51 ) with the highest accuracy had a sensitivity of 98.0 % and specificity of 96.2 %.Conclusions RI was most significantly associated with malignancy. The combination of RI and gray-scale sonography can maximize the ability to discriminate between benign and malignant ovarian tumors.

ObjectiveTo compare the accuracy of enhanced dynamic wedge (EDW) models of adaptive convolution algorithm (ACA) in Pinnacle3 9.0 and anisotropic analytical algorithm (AAA),and pencil beam convolution (PBC) algorithms in Eclipse7.3 treatment planning systems (TPS).MethodsTo evaluate the accuracy of the three algorithm models,we compared actual measurement values with TPS calculation values of EDW wedge factors under for different fields in which Varian-21EX 6 MV X-ray was applied,and also compared the actual dose distribution profile with that of TPS.ResultsThe deviations of EDW wedge factors of symmetry fields and asymmetric fields are within 2.8％ and 19.4％ for ACA in Pinnacle3 9.0.Meanwhile,the deviations are 1.0％ and 2.0％ for AAA,1.2％ and 3.0％ for PBC in Eclipse7.3.The deviations between measurement and calculation of all fields profile for ACA is within 3％ and within 2.7％ for AAA within 4.0％ for PBC in wedge direction.For the dose distributions,we evaluated the pass rates of three algorithms using gamma analysis.The gamma pass rates among all the three algorithms in symmetry and asymmetric fields are above 87％ and 85％ respectively.After the removal of the penumbra zone,the pass rates among all the three algorithms are above 96％ in symmetry fields,and above 95％ in asymmetric fields,respectively.Conclusions AAA and PBC algorithms in symmetric and asymmetric fields can meet the need of clinical applications.While,wedge factor of ACA should not be used in clinical due to its greater error in asymmetric fields.

A Comprehensive review was present on the sources, enzyme stru cture, enzyme reaction mechanism and the application of the nitrilase.

The implementation of the Malpractice Handling Regulations provides medical institutions with a new framework for guarding against and handling medical disputes. Compared with the Methods for Handling Malpractices, it has many merits. However, as a newly published set of laws and regulations, it will doubtlessly be tested and challenged in one way or another in actual practice. The authors attempt to present their viewpoints from the following perspectives. Firstly, the determination of the nature of a malpractice ought to be linked with the degree of involvement in it, and it is unwise to take cases of minor liabilities as malpractices. Secondly, the rules for identifying the degree of a malpractice in negotiated settlement fall short of being reasonable and are not easy to implement, thus adding to the difficulty of negotiated settlement. Thirdly, is the stipulation of compensation for malpractices only fair, sensible and legal? Is it conducive to the negotiated settlement of medical disputes? Fourthly, since the Malpractice Handling Regulations are lacking in attention to the problem of lengthy lingering in the hospital on the grounds of malpractices, the authors put forward the suggestion that administrative laws and regulations of health ought to provide necessary support in terms of health laws and regulations for the judicial settlement of such cases.

BackgroundThe study of myopia development is always the hotspot worldwide. Recently,scientist found that some growth factor secreted by retinal nerve epithelium cells and retinal pigment epithelium(RPE)cells are associated with the development of myopia. Whenever, the absorption of RPE cells to different wave-length lights is different. ObjectiveThis study was to investigate the effects of different wave-lengths lights on the proliferation of human RPE cells, and explore the influence of different wave-lengths lights on RPE cells secreting hepatocyte growth factor(HGF) ,basic fibroblast growth factor(bFGF) and transforming growth factor-β(TGF-β).Methods The fourth to fifth passages of human embryonic RPE cells were exposed to blue light( λ =480 nm),red light( λ =775 nm) and white light. The cells of control group were harvested in normal condition. The proliferation and growth of RPE cells were assayed by MTT,and the ultrastructure of cells was examined under the transmission electron microscopy at 48 hours after light exposure of RPE cells. Enzyme linked immunosorbent assay(ELISA) was adopted to determine the concentrations of HGF,bFGF and TGF-β in the culture medium in 12,24,48,72 hours. The expression of HGF mRNA in RPE cells was detected by RT-PCR. This study was approved by Ethic committee of Fudan University. ResultsThe A490 values of the cells exposed to blue light,red light,white light and white light were 0. 0218±0. 0014 ;0. 0353±0. 0025 ;0. 0371 ±0. 0024 and 0. 0445 +0. 0046 respectively with the significant difference among 4 groups ( F =12. 579, P＜0.05 ), and A490 value in blue light group, red light group were significantly lower than that of the control group ( t =2.043 ; t =2.024, P＜0.05 ). ELISA showed that the concentrations of HGF and TGF-β in culture medium were evidently elevated as the prolongation of light exposure in various light exposure groups in 72 hours(HGF) and 48 hours(TGF-β) compared with 12 hours with a predominating rise in the control group. The statistically significant differences were found in the concentrations of HGF and TGF-β between control group and blue light group or red light group in the( all P＜0. 05 ). The bFGF level was decreased with the time increase of various light exposure with the significant differences in 72 hours compared with 12 hours( P＜0.05 ). RT-PCR revealed the considerable difference about expression of HGF mRNA in RPE cells among these four groups( P＜0. 05 ), and the lest expression in HGF mRNA was in the blue light group compared with control group( t =3. 972,P＜0.05 ). Thinning of the chromatin, decreasing of organelle and loss of cellular membrane were seen in the blue light group, but no obvious change of ultrastructure of human embryo RPE cells was found in the ret and white light groups. ConclusionsThe irradiation of different wave-length light can effect the growth and proliferation and secretion of HGF,bFGF and TGFβ in human RPE cells in vitro,implying myopia formation is associated to exposure of different wave-length light.

The construction and management working of clinical practice teaching base is an important component of the western medical colleges and universities.The colleges and universities highlights the status of clinical practice teaching base construction,such as improving construction management system of clinical practice teaching base,strengthening the basic teaching facilities construction,the teachers troop construction and the system construction of clinical practice teaching base,strengthening the organization,teaching and funds management of the clinical practice teaching base and improving the quality and level of graduation practice.

OBJECTIVETo evaluate the operation time and clinical effect of three types of materials (i.e., total-etching adhesive, self-etching adhesive, resin-modified glass ionomer cement) that are used to bond removable thermoplastic appliances.

METHODSThirty malocclusion patients (156 attachments) with removable thermoplastic appliances were randomly divided into three groups, with 10 individuals each. Attachments of groups A and B were bonded using 3M Adper Single Bond 2 and 3M Adper Easy One, respectively; both adhesives utilized 3M Z350 nano composite resin. Attachments of group C was directly bonded using GC Fuji Ortho LC. The operation time of each attachment was recorded. Failure rates of adhesion were evaluated during adhesion, 1 month after treatment, and 6 months after treatment.

RESULTSThe operation time of group C was shorter than those of groups A and B (P<0.01). Significant difference of adhesion failure rates was not found among the three groups (P>0.05). No significant difference of adhesion failure rates was also observed in different times of the same group (P>0.05).

CONCLUSIONThe attachment stability of the three types of materials achieved satisfactory effects. However, the operation method of resin-modified glass ionomer cement is more concise and suitable for clinical promotion.

Acrylic Resins ; Adhesives ; Aluminum Silicates ; Composite Resins ; Dental Bonding ; Dental Cements ; Glass Ionomer Cements ; Humans ; Orthodontic Appliances ; Resin Cements